Analysis of appropriateness of thyroid function test ordering in a tertiary care hospital.

Dr Advani Manjari; Dr Mali Smita; Dr Pawar Sudhir; Mrs George Surya; Mrs Mali Varsha

Volume : VIII, Issue : II, February - 2019

Analysis of appropriateness of thyroid function test ordering in a tertiary care hospital.

Dr Advani Manjari, Dr Mali Smita, Dr Pawar Sudhir, Mrs George Surya, Mrs Mali Varsha

Abstract :

Introduction: Appropriate use of the diagnostic thyroid function tests (T3, T4 & TSH) remains controversial as it is mainly TSH levels which guide treatment.

Aim: To evaluate the appropriateness of ordering of TFT in a public sector hospital.

Methodology: It was a retrospective observational study conducted in a tertiary care public sector hospital. Outcome of TFT was analyzed and correlated with appropriateness of ordering as per the selected guidelines.

Results: During the period of 3 years total 3325 patients were referred for thyroid function test. 78% of the TFT ordering was as per guideline. Our analysis found that proportion of dysthyroid cases being detected in the tests ordered as per guidelines was significantly higher as compared to tests which were not (odds ratio 1.83 (95% confidence interval 1.442 to 2.323). Proportion of dysthyroidism detected was higher in patients having more than one system involved. Serum T3 and T4 were found to be deranged in only 51 out of 633 dysthyroid patients.

Summary: In Public sector hospitals resources could be conserved by not only ordering only TSH as a test for primary screening but also when more than one symptomatic indication is present.